PDC Pediatric Dental Care PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PDC PEDIATRIC DENTAL CARE PLLC

Practice address

9901 Fairfax Blvd
Fairfax, VA 22030-1740

Phone

(703) 383-3434

NPI assigned

Jan 10, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victoria Johnson

Title

Cro

Phone

(941) 444-0558

Specialties & licenses 1

Addresses

Other names 1

• Dental Care Alliance Other name

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sammy Gurman, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fairfax, VA
  • NPI 1063166742
  NPD
• John Han, D.D.S.

  • Pediatric Dentistry
  • Fairfax, VA
  • NPI 1780781351
  NPD
• Jenny Y Ha, DDS

  • Pediatric Dentistry
  • Riverside, CA
  • NPI 1114158748
  NPD (past)
• Celeste Ama Mensah, D.D.S.

  • Pediatric Dentistry
  • Lancaster, PA
  • NPI 1437532579

  Dentist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1700547932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 FAIRFAX BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220301740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 FAIRFAX BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220301740",
            "telephone_number": "703-383-3434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6120 Brandon Ave Ste 114",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221502504",
            "country_code": "US",
            "telephone_number": "703-992-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PDC PEDIATRIC DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "941-444-0558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care Alliance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Renee Payne, MD
• Orit Paytan, LCSW
• Erika Paz
• Courtney Pazienza, RDN
• PD Dental PLLC
• Eleanor Garrett Peacock, MS
• Kristin Pearl
• Sarah Sheasby Pearson, FNP-BC
• Jessica L Peckins
• Lauren Kelli Peckl

• All providers in Fairfax, VA
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.